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A Comparative Study of 0.0625% Levobupivacaine with Fentanyl Versus 0.1% Ropivacaine with Fentanyl for Continuous Epidural Labor Analgesia

Ravi Saravanan , Mahalakshmi Annadurai1 , Saravanan Ravi2 , Gayathri Ramanathan3 , Karthik Mani4

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Indian Journal of Anesthesia and Analgesia 6(5):p 1583-1589, September-October 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.14

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Mahalakshmi Annadurai, Saravanan Ravi, Gayathri Ramanathan et al. A Comparative Study of 0.0625% Levobupivacaine with Fentanyl Versus 0.1% Ropivacaine with Fentanyl for Continuous Epidural Labor Analgesia. Indian J Anesth Analg. 2019;6(5 Part-1): 1583-1589.

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Abstract

Background: Ropivacaine and Levobupivacaine are newer local anesthetic agents in obstetric practice for labor epidural analgesia which have got advantages of less motor blockade and systemic toxicity compared to Bupivacaine. Objective: To compare the efficacy of equipotent doses of Ropivacaine 0.1% and Levobupivacaine 0.0625% with fentanyl as continuous infusion for labor epidural analgesia. Study Design: A Prospective randomized control trial. Methods: After obtaining the institutional ethics committee approval, Patients who met the inclusion criteria were randomly allocated to group B and group R (20 patients in each group) by computer generated random numbers. Patients were randomly assigned to receive either 10 ml of 0.2% ropivacaine or 10 ml of 0.125% levobupivacaine followed by infusion of 0.1% ropivacaine with fentanyl 2 mcg/ml or 0.0625% levobupivacaine with fentanyl 2 mcg/ml at 8 ml/hr continuous epidural infusion. Visual analogue scale (VAS) before epidural bolus dose and throughout the labor were recorded. Maternal heart rate, blood pressure, oxygen saturation, fetal heart rate, maximum sensory level achieved and degree of motor blockade were recorded every fifteen minutes. Results: The demographic variables were comparable between the two groups. There was no significant difference in the onset of pain relief, VAS scores during the infusion and level of Sensory block. There was no difference found in the hemodynamic parameters, delivery outcome, patient satisfaction and neonatal outcome. Conclusion: Epidural Levobupivacaine provides good and effective analgesia as Ropivacaine for labor pain and hence, a good alternate local anesthetic in labor epidural analgesia with cost limitations.

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Mahalakshmi Annadurai, Saravanan Ravi, Gayathri Ramanathan et al. A Comparative Study of 0.0625% Levobupivacaine with Fentanyl Versus 0.1% Ropivacaine with Fentanyl for Continuous Epidural Labor Analgesia. Indian J Anesth Analg. 2019;6(5 Part-1): 1583-1589.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.14

Keywords

Epidural; Labor analgesia; Levobupivacaine; Ropivacaine.

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